Asma Naseer Cheema, Attya Bhatti, Jabar Ali, John Peter.
Association of Non-Genetic Risk Factors with Coronary Artery Disease in Pakistani Population.
Ann Pak Inst Med Sci Jan ;12(2):101-7.

Objective: The objective of our study was to assess the association of various risk factors with clinically determined and angiographically assessed CAD in Pakistani population. Materials & Methods: We determined the CAD phenotype both clinically andby angiography in 663 subjects. Participants with ≥70% stenosis were taken as patients and <30% stenosis/no stenosis as controls. Serum was analyzed for lipid profile, Blood sugar fasting and creatinine. Differences in mean values for age, body mass index (BMI) and lipid levels were analyzed using one-way ANOVA. Chi-square(࣑(૛test was performed for sex, smoking and family history of CAD to see the difference among three stenosis groups. To assess risk factors for coronary stenosis and dyslipidemia, we performed the regression analysis. MedCalc 11.6 was used for Receiver operating curve (ROC)analysis and to determine the cut off for our significant quantitative variables. The subjects were divided into groups for continuous variables after choosing Internationally established cut-off values. Results: We had 663 subjects (22.3% females, mean age = 54 ± 11 years) for association of environmental risk with CAD. After angiography, there were 506 patients with >70% stenosis and 157 controls with <30% stenosis. BMI appeared as a moderate risk factor with Area under curve (AUC) of 0.58; p=0.002 with 61% sensitivity and 54% specificity. LDL-C is 62% sensitive and 52% specific to predict the disease at cut-off 105mg/dL with AUC=0.61; p=0.03. The OR in diabetic group (BSF>126mg/d) to develop hypertriglyceridemia was 1.014(1.006-1.023) with p-value<0.001 Vs. non-diabetics. The age group with less than 40 years showed protection against dyslipidemia by high HDL levels with OR 0.941(0.900-0.984); p-value=0.008 as compared to >40 years age group. BMI was significantly different in Normal, high normal and hypertensive patients(p=0.004). Conclusion: Men are more prone to develop CAD before the age of 40 years. High BMI, LDL-C and hypertension are significant risk factors for coronary stenosis, Diabetes mellitus and advanced age are substantial risks for developing dyslipidemia and BMI appeared as important risk factor for hypertension in Pakistani population.

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